Do you have a stress fracture?

A stress fracture can also be known as a hairline fracture or a fatigue fracture. It is a small crack in the bone that is usually caused a repetitive force that the body can't handle. It can occur in any bone but it most often occurs in the foot (metatarsal) or shin (tibia) bones -- the weight bearing bones. A fracture in the foot is often referred to as a top of foot pain injury.

It is often referred to as a fatigue fracture because it occurs when the muscles become fatigued and can no longer absorb the stress and protect the bone. The bone cannot absorb the shock and cracks. It is a common injury among long distance runners and it is more common in women than in men. Women commonly experience bone density loss more so than men mainly because of menstrual irregularities.

How do I know if I have a stress fracture?

Stress Fracture

These fractures can be difficult to diagnose as x-rays will not initially show the fracture. After several weeks, it may show evidence around the affected area of the bone attempting to heal the fracture.

There is usually tenderness and swelling in a specific point directly over the injury. Gently tapping on the bone will cause pain, which is not the case if you have a soft issue injury.

You will experience pain while running in the affected bone that continues to get worse. The pain often subsides when resting. To confirm a stress fracture, your physician will check the history of your injury and perform a physicial exam. An MRI or bone scan may also be necessary to determine the cause of your foot pain or shin pain.

What caused my stress fracture?

A fracture can be caused by a number of factors. The most common is a rapid increase in training activity over a short period of time and not following a proper training plan. Increases in time, type or intensity of any training activity should be done gradually.

These fractures can also be caused by poor bone health as a result of poor nutrition or menstrual irregularities. Age may also be a factor as the muscles in an older person's body are more easily fatigued.

Other factors include:

  • Improper or old footwear
  • An abrupt change of footwear
  • An abrupt change of running surfaces
  • Running on hard surfaces
  • Insufficient or decling fitness
  • A return to running too quickly from a previous injury
  • High arched feet
  • Under-pronation or subination
  • Over-pronation
  • Longer second toe
  • Bunions

How to recover from a stress fracture

To recover from a fracture, you need to rest for 6 to 8 weeks. You must not run or you risk developing a full fracture, which will greatly increase the amount of recovery time. Do not bear weight on the area if it causes pain. Crutches or a cast may be necessary. A good guide to follow is: If it causes pain, don't do it!


Ice the area to reduce swelling and do other activities to maintain your fitness. Safe activities could include deep water running, spin classes or an Alter-G antigravity treadmill if available in your area. Eat well and include calcium-rich foods. This is especially important for women.

Work on improving your running posture or technique and ensure you are wearing the best running shoes for your feet. You should be pain free for two weeks before returning to running.

You may also be interested in these articles:

Top of Foot Pain

Shin Splints

9 Tips for Injury Prevention

Return From Stress Fracture Back to How to Prevent Injuries

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